NPIMap

Organization Active NPI

Key Therapy LLC

  • Marriage & Family Therapist
  • Monroe, CT
National Provider Identifier
1114393493
Registry record updated Jul 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
001736 Issued in CT
Legal business name
KEY THERAPY LLC
Practice address
731 Main St Ste 122
Monroe, CT 06468-2872
Phone
(203) 261-7090
Fax
(888) 856-3413
NPI assigned
Aug 20, 2015
Last updated
Jul 24, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Samantha Lee Birtwell, MANPI 1598176018
Title
LMFT
Phone
(203) 300-6414

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 001736 CT Primary

Addresses

Primary practice location

731 Main St Ste 122
Monroe, CT 06468-2872

Mailing address

13 Roosevelt Dr
Newtown, CT 06470-2035
Phone (203) 300-6414

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180827003149 CT Part B Supplier - Clinic/Group Practice 6204185010 Receives reassigned benefits from 24 practitioners
Practice locations: Monroe, CT

National Provider Directory

National Provider Directory

Locations

731 Main St
Ste 122
Monroe, CT 06468
Phone (203) 261-7090

755 Main St
#3B
Monroe, CT 06468

755 Main St
#8B
Monroe, CT 06468

Practitioners & affiliated clinicians

Practitioners 38

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 38

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1440028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595548800000",
    "number": "1114393493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 ROOSEVELT DR",
            "city": "NEWTOWN",
            "state": "CT",
            "postal_code": "064702035",
            "telephone_number": "203-300-6414",
            "fax_number": "888-856-3413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 MAIN ST STE 122",
            "city": "MONROE",
            "state": "CT",
            "postal_code": "064682872",
            "telephone_number": "203-261-7090",
            "fax_number": "888-856-3413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEY THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-20",
        "last_updated": "2020-07-24",
        "certification_date": "2020-07-24",
        "status": "A",
        "authorized_official_last_name": "BIRTWELL",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "LMFT",
        "authorized_official_telephone_number": "203-300-6414",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CT",
            "license": "001736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.